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Case study: The formation of the National Health Service

The idea of national co-ordination of the health services and the supply of free medical care to all gained popular and political support during the 1930s and 1940s, and was included in the recommendations of the 1942 Beveridge Report. In 1944 the Ministry of Health (under the war-time coalition government) published a White Paper on a National Health Service, which put forward detailed proposals for a system of free universal healthcare funded by central taxation. In 1945 the Labour Party won a landslide general election and the new Minister of Health, Aneurin Bevan, was given the task of creating a workable system and manoeuvring all the various vested interests into agreement. His National Health Service Act of 1946 established a structure for the NHS in England and Wales, and, unlike the earlier White Paper, proposed that the health service should be managed by central government rather than local authorities. Strong disagreement over the proposed service, particularly between the government and the British Medical Association (representing doctors), almost threatened to derail the implementation of the Act, but the new National Health Service was launched as planned in July 1948.

Looking at the documents:

These digitised documents are included in our online collection of documents relating to British healthcare between 1900-1948 - a free resource which includes more examples of documents about the formation of the National Health Service. Click on the thumbnails and links in the sections below to see the whole document. Once you have opened the document, use the + and - sliding scale immediately above the image to zoom in and out. Click on the 'Next' and 'Previous' buttons (above the 'Print' and 'Download' buttons) to move to the next and previous pages.


Document 1

'Health service or "panel"?', 1945

Leaflet issued by the Socialist Medical Association. The SMA was in favour of a comprehensive state run health service and produced a series of leaflets in the mid 1940s which attacked the attitude of the British Medical Association (BMA) towards a national health service. In this leaflet the author criticises the BMA's health care proposals and accuses the organisation of acting on behalf of vested interests (doctors), rather than the medical profession or nation as a whole.

[Included in a file on the National Health Service, 1944-1945, from the archives of the Trades Union Congress; document reference: 292/847/3]


Document 2

British Medical Association and the National Health Service Bill, 1946
The British Medical Association and the National Health Service Bill, 1946

In this policy statement, the BMA puts foward its objections to some of the government's proposals for a unified health service. This document also includes a statement by the Negotiating Committee (containing representatives of the BMA, the Royal Colleges, the Royal Scottish Medical Corporations, the Society of Medical Officers of Health, the Medical Women's Federation and the Society of Apothecaries) on the subject of a national health service.

[Included in a file on the National Health Service, 1946, from the archives of the Trades Union Congress; document reference: 292/847/4]


Document 3

'National Health Service: You must decide', January 1948

Circular issued by the Medical Practitioners' Union six months before the National Health Service Act came into effect. It gives answers to key questions affecting the union's members, such as 'is change inevitable?', 'is change fair to the doctor?', and 'is change needed?'.

[Included in a file on National Health Service, 1946-1952, from the archives of the Trades Union Congress; document reference: 292/847/5]


Document 4

Comments on editorial in American Medical Association Journal, 1948
"The greatest folly in the world"? 1948

The American Medical Association journal of 25 September 1948 included a strong attack on the "folly" of the National Health Service. This response was produced by the British Trades Union Congress. It criticises the original article for inaccuracy and exaggeration, and puts forward a defence of the newly formed health service.

[Included in a file on National Health Service, 1946-1952, from the archives of the Trades Union Congress; document reference: 292/847/5]


Document 5

"Public Health in 1948: Remarkable Statistics", 31 March 1950
"Public Health in 1948: Remarkable Statistics", 31 March 1950

This is an eight page summary of the Ministry of Health's annual report for March 1948/1949 (including the first nine months of the National Health Service). The report highlights the "striking reductions" in death rates over this period and provides an outline of the "administrative revolution" resulting from the launch of the NHS.

[Included in a file on National Health Service, 1946-1952, from the archives of the Trades Union Congress; document reference: 292/847/5]


Document 6

Conservative Party election leaflet, 1950
'Are you better off?', 1950

General election leaflet issued by the Conservative Party. It criticises key policies introduced by the Labour government over the previous five years. The National Health Service (credited to the wartime coalition government headed by Winston Churchill, leader of the Conservative Party) is said to be endangered by "wasteful mismanagement" of the socialists.

[Included in a file of publicity material for 1950s general elections, part of the archives of the Transport and General Workers' Union; document reference: 126/TG/RES/X/1004A/2]